Functional brain controllability in Parkinson's disease and its association with motor outcomes after deep brain stimulation

Ziyu Li; Zhiqin Liu; Yuan Gao; Biqiu Tang; Shi Gu; Chunyan Luo; Su Lui

doi:10.3389/fnins.2024.1433577

Functional brain controllability in Parkinson's disease and its association with motor outcomes after deep brain stimulation

Front Neurosci. 2024 Nov 7:18:1433577. doi: 10.3389/fnins.2024.1433577. eCollection 2024.

Authors

Ziyu Li^#^{1

2}, Zhiqin Liu^#^{1

2}, Yuan Gao³, Biqiu Tang^{1

2}, Shi Gu⁴, Chunyan Luo^{1

2}, Su Lui^{1

2}

Affiliations

¹ Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Guoxue Xiang, Chengdu, China.
² Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Guoxue Xiang, Chengdu, China.
³ Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
⁴ School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China.

^# Contributed equally.

Abstract

Introduction: Considering the high economic burden and risks of deep brain stimulation (DBS) surgical failure, predicting the motor outcomes of DBS in Parkinson's disease (PD) is of significant importance in clinical decision-making. Functional controllability provides a rationale for combining the abnormal connections of the cortico-striato-thalamic-cortical (CSTC) motor loops and dynamic changes after medication in DBS outcome prediction.

Methods: In this study, we analyzed the association between preoperative delta functional controllability after medication within CSTC loops and motor outcomes of subthalamic nucleus DBS (STN-DBS) and globus pallidus interna DBS (GPi-DBS) and predicted motor outcomes in a Support Vector Regression (SVR) model using the delta controllability of focal regions.

Results: While the STN-DBS motor outcomes were associated with the delta functional controllability of the thalamus, the GPi-DBS motor outcomes were related to the delta functional controllability of the caudate nucleus and postcentral gyrus. In the SVR model, the predicted and actual motor outcomes were positively correlated, with p = 0.020 and R = 0.514 in the STN-DBS group, and p = 0.011 and R = 0.705 in the GPi- DBS group.

Discussion: Our findings indicate that different focal regions within the CSTC motor loops are involved in STN-DBS and GPi-DBS and support the feasibility of functional controllability in predicting DBS motor outcomes for PD in clinical decision-making.

Keywords: Parkinson’s disease; cortico-striato-thalamic-cortical (CSTC) motor loops; deep brain stimulation; functional controllability; motor outcomes.

Grants and funding

The authors declare that financial support was received for the research, authorship, and publication of this article. This study was supported by National Key R&D Program of China (Project Nos.2022YFC2009901, 2022YFC2009900), the National Natural Science Foundation of China (Project Nos. 82120108014, 82071908), Sichuan Science and Technology Program (Project No. 2021JDTD0002), Chengdu Science and Technology Office, major technology application demonstration project (Project Nos. 2022-YF09-00062-SN, 2022-GH03-00017-HZ), 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (Project Nos. ZYGD23003, ZYAI24010), and the Fundamental Research Funds for the Central Universities (Project No. ZYGX2022YGRH008).